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Small Baby...Having Latching Problems...

So in the beginning, breastfeeding seemed to be going well and there was no pain. (I didn't talk to the lactation consultants in the hospital btw; they were more concerned with putting her on a feeding schedule than making sure I was doing things properly...which made me uncomfortable with them and since things were going well anyway I didn't ask them anything.)

Well about a week later I started getting really really bad (tear-inducing) nipple pain. I'm not sure if she changed her latch, or if we just didn't have it down in the beginning and it took a week to get sore. Anyway, my breasts were also fairly hard and painful in spots as well. After extensive googling, we figured out she most likely had an improper latch. (Also that I should massage the hard spots on my breasts while she nursed...they are doing much much better...are soft and don't hurt anymore,) We found lots of info on how to latch properly (asymmetrical). The problems are:

1. Most sites said to position the baby in the beginning with her nose at nipple level. My nipples point down (not out...when she's in football, she's basically on her back UNDER my breast for the nipple to get in her mouth) and my breasts are much fuller above than below, so if I start her like that, her nose is buried in my breast. Does that really make a difference?

2. She either won't open her mouth wide enough, or she will clamp down too soon, or both. She's not getting enough of the areola in her mouth, and no matter what I do to try to get her to get more in, it doesn't happen. My nipples are sore, pink, and when she lets go of them (or I decide I have too much pain and take her off to rest a minute) they are white (vasospasm? It only happens sometimes that they are white). Someone also told me to start her with my breast on her chin, which will make her open wide...still not wide enough.

3. I read some places that said NOT to adjust the latch until she decides to let go, and some places said keep re-latching her until she gets it. Which is right? (Obviously if it's too painful I try again!) Sometimes I'll try and try to get her to get it right and she doesn't, even if the last 5 times she got it. Does this mean she's not hungry?

I want to be able to do this without pain!! She's just 3.5wks old too...not even due until the 30th lol! She was 5.5lb at her 2wk appointment. (5lb at birth) I'm fairly certain I don't have thrush; I KNOW her tongue isn't tied (it's really long!! lol); she just doesn't get enough areola in her mouth. Oh and when she finally lets go/gets off, my nipple is short, like squished side to side however her mouth was. She has a great suck.

Oh also what about when she lets go of me (or hurts my nipple so I get her off) and acts like she wants back on, but then decides she's fine? Is she still hungry, or satisfied enough?

Re: Small Baby...Having Latching Problem

Welcome and congratulations on the new baby! Based on what you've posted, I think a visit with a lactation consultant, preferably an IBCLC, would be a really good idea. Nothing beats hands-on help when you have a latch issue with a newborn. Please don't go back to those people who were calling themselves LCs at the hospital- no LC who knows what she is doing makes scheduling a baby her primary concern. And schedules and breastfeeding don't mix: in general, the best schedules are those babies design for themselves, although with very young, very small, or jaundiced babies it is important to wake the baby to feed every 2-3 hours even if the baby prefers to sleep.

Hee are a few things that may help you right now:
- see the IBCLC
- experiment with different nursing positions, see if there's something that works better for you
- go topless/braless as much as possible to reduce chafing to sore nipples, and also to reduce the risk of plugged ducts from a poor-fitting bra (those hard spots in your breasts were almost certainly plugged ducts)
- google "nipple sandwich techniques" for a description of a method for cramming the maximum amount of breast into a small mouth
- support the breast throughout the feeding using your hand or a rolled-up washcloth tucked under the breast
- try to latch baby on before she gets really hungry. Hungry babies get so frantic that they can't latch well.
- if baby is getting frantic, opening and closing her mouth and is therefore unable to latch well, try offering her your pinky finger to suck, with nail held down towards her tongue. After a few seconds of sucking a finger, she may have calmed down enough to enable another latch attempt.
- if the latch is really painful, do not be afraid to take baby off the breast and try again.
- if baby unlatches or is unlatched and wants the breast again, give it to her. If she only spends a moment sucking and then comes off on her own, she's probably done.
- watch diaper output carefully. When you have a newborn with a latch problem, you want to make extra sure that she's getting enough to eat. If that means being a bit obsessive aout number of wet and poopy diapers, so be it.

Re: Small Baby...Having Latching Problem

How about calling an lll leader in your area and explaining the problem? She might know someone you could see. How do you get to doc appts? This is your baby's feeding, andis just as important (if not more!) than doc appts, so if you rely on a partner for transport, he/she needs to take this just as seriously.

Kate

Mother to a sweet boy, born at 34 weeks on 2/11/11.
Proud that I grew 26 lbs of baby before solids, and still counting...

Re: Small Baby...Having Latching Problem

with katmar. If you're seeing good poop output and weight gain, then you have the basics right and you just need to tweak the fine points. Not to minimize what you're going through, but seriously, good milk intake is a fundamental measure of success and it sounds like you've nailed it.

Spitting up isn't a big deal as long as it occurs without pain. If the baby isn't crying or screaming when spitting, then the spit is a laundry issue and not a health issue. Who knows why it starts when it does? I know my second started urping at around 3 weeks old and didn't stop until around 6 months.

Re: Small Baby...Having Latching Problem

Some IBCLCs will do housecalls.

You can find one by looking them up on the IBCLC website or even calling the hospital, contacting your OB or midwife for a referral or calling your local LLL Leader. Your LLL leader may also be able to come over and give you some tips. She can't diagnose problems, but she can sure help you out.